L-ascorbic acid induces apoptosis in human laryngeal epidermoid Hep-2 cells by modulating the nuclear factor kappa-light-chain-enhancer of activated B cells/ mitogen-activated protein kinase/Akt signaling pathway

L-ascorbic acid (L-AA; vitamin C) induces apoptosis in cancer cells. This study aimed to elucidate the molecular mechanisms of L-AA-induced apoptosis in human laryngeal epidermoid carcinoma Hep-2 cells. L-AA suppressed the viability of Hep-2 cells and induced apoptosis, as shown by the cleavage and condensation of nuclear chromatin and increased number of Annexin V-positive cells. L-AA decreased Bcl-2 protein expression but upregulated Bax protein levels. In addition, cytochrome c release from the mitochondria into the cytosol and activation of caspase-9, -8, and -3 were enhanced by L-AA treatment. Furthermore, apoptosis-inducing factor (AIF) and endonuclease G (EndoG) were translocated into the nucleus during apoptosis of L-AA-treated Hep-2 cells. L-AA effectively inhibited the constitutive nuclear factor-κB (NF-κB) activation and attenuated the nuclear expression of the p65 subunit of NF-κB. Interestingly, L-AA treatment of Hep-2 cells markedly activated Akt and mitogen-activated protein kinase (MAPK; extracellular signal-regulated kinase 1/2, p38, and c-Jun N-terminal kinase [JNK]) and and LY294002 (Akt inhibitor), SB203580 (p38 inhibitor) or SP600125 (a JNK inhibitor) decreased the levels of Annexin V-positive cells. These results suggested that L-AA induces the apoptosis of Hep-2 cells via the nuclear translocation of AIF and EndoG by modulating the Bcl- 2 family and MAPK/Akt signaling pathways.

L-ascorbic acid induces apoptosis in human laryngeal epidermoid Hep-2 cells by modulating the nuclear factor kappa-light-chain-enhancer of activated B cells/ mitogen-activated protein kinase/Akt signaling pathway

L-ascorbic acid (L-AA; vitamin C) induces apoptosis in cancer cells. This study aimed to elucidate the molecular mechanisms of L-AA-induced apoptosis in human laryngeal epidermoid carcinoma Hep-2 cells. L-AA suppressed the viability of Hep-2 cells and induced apoptosis, as shown by the cleavage and condensation of nuclear chromatin and increased number of Annexin V-positive cells. L-AA decreased Bcl-2 protein expression but upregulated Bax protein levels. In addition, cytochrome c release from the mitochondria into the cytosol and activation of caspase-9, -8, and -3 were enhanced by L-AA treatment. Furthermore, apoptosis-inducing factor (AIF) and endonuclease G (EndoG) were translocated into the nucleus during apoptosis of L-AA-treated Hep-2 cells. L-AA effectively inhibited the constitutive nuclear factor-κB (NF-κB) activation and attenuated the nuclear expression of the p65 subunit of NF-κB. Interestingly, L-AA treatment of Hep-2 cells markedly activated Akt and mitogen-activated protein kinase (MAPK; extracellular signal-regulated kinase 1/2, p38, and c-Jun N-terminal kinase [JNK]) and and LY294002 (Akt inhibitor), SB203580 (p38 inhibitor) or SP600125 (a JNK inhibitor) decreased the levels of Annexin V-positive cells. These results suggested that L-AA induces the apoptosis of Hep-2 cells via the nuclear translocation of AIF and EndoG by modulating the Bcl- 2 family and MAPK/Akt signaling pathways.

Patch Test (T.R.U.E. Test) Results in Patients with Allergic Contact Dermatitis: 2007~2011, Chungcheongnamdo / 대한피부과학회지

BACKGROUND: A number of skin manifestations in patients with allergic contact dermatitis result from sensitization with specific allergens, and patch testing is used as a diagnostic means of identifying theses allergens. In Korea, the commercial patch test panel, the TRUE-test, has been available since 2005. However, there have been few reports regarding the results of the TRUE-test. OBJECTIVE: The purpose of this study was to analyze the type, frequency, and changes in common contact allergens in Korea using the TRUE test. METHODS: A total of 311 patients with allergic contact dermatitis were evaluated by the TRUE test between January 2007 and December 2011 at Soonchunhyang hospital. Patch test reading was performed on day 2 and day 4. RESULTS: A total of 311 cases of TRUE test records (male 79, female 232) were compiled and analyzed. The highest age distribution was the 4th decade in females. The face, with exception of the lips, was the most frequently affected site (40.2%). Overall, 58.8% of patients had at least on positive reaction, and the most common allergens were nickel sulfate (31.8%), p-phenylenediamine (13.5%), cobalt chloride (10.0%), thiomersal (7.4%), and carba mix (5.5%). Nickel allergen displayed higher positive rates than the rates in other countries. CONCLUSION: There was no significant difference in the overall positive rate of patch test results compared with recent studies. However, we confirmed that metal-related allergens remain the most common, and that the results provide the basis for the use of the TRUE test in patients with contact dermatitis in Korea.

A Clinical and Mycological Study of Dermatophytoses in Chungcheongnam-do Province (2008~2012) / 대한의진균학회지

BACKGROUND: The causative organisms and clinical characteristics of dermatophytoses are altered by various factors such as social environmental change and geographic distribution. OBJECTIVE: The purpose of this research is to investigate the changes and recent clinical and mycological features of dermatophytoses in the Chungcheongnam-do province. METHODS: We performed clinical and mycological studies on 387 cases of dermatophytoses among outpatients of Dermatologic clinic of Soonchunhyang University Cheonan Hospital for 5 years, from January 2008 to December 2012. RESULTS: 1. The age distribution showed patients in their 50s to be the most common. The ratio of male to female was 1.07:1. 2. The seasonal prevalence of dermatophytoses was highest in the summer, but the incidence of tinea capitis was highest in the winter season. 3. The positive rate of KOH examination was 95.1% and that of culture was 58.9%. 4. Trichophyton(T.) rubrum was most prevalent dermatophyte (71.1%), followed by Microsporum(M.) canis (9.2%), T. mentagrophytes (7.9%). CONCLUSION: Compared with previous study, the incidence of T. rubrum infection is rising and in recent years the prevalence of M. canis infection has markedly increased. The rest of causative organisms' proportion is increasing and diversification is observed.

Ulcerated Perianal Infantile Hemangioma Treated with Propranolol / 대한피부과학회지

Infantile hemangioma is a self-resolving benign tumor that commonly requires no intervention. Despite its distinctive, self-limiting course, infantile hemangiomas may result in ulcerations that cause pain, potential scarring, bleeding, and infection. Active treatment is usually required to manage these lesions. The discovery of propranolol in the treatment of infantile hemangioma was described in 2008 by Leaute-Labreze, et al. Since then, its effectiveness and safety have been confirmed by several cases, and replacing systemic corticosteroids as a first-line therapy. Herein, we report the successful treatment of children with ulcerated perianal infantile hemangioma with propranolol.

Pachyonychia Congenita Affecting the Nails Only in the Mother and Son / 대한피부과학회지

Pachyonychia congenita (PC) is a rare autosomal-dominant ectodermal dysplasia, which is characterized by hypertrophic nail dystrophy, diffuse or focal symmetrical hyperkeratosis of the palms and soles, oral leukokeratosis, follicular keratosis on the extensor surfaces of the extremities, and other ectodermal defects. However, the variable degree of gene mutation may result in nail abnormalities alone. The nail changes presented in our patient are the only clinical manifestation. Hypertrophic nail dystrophy and yellowish discoloration, without involving any other organs, were shown in both mother and baby since birth. To the best of our knowledge, the case of PC affecting only the nails has never been reported in Korea before. Herein, we report monosymptomatic form of PC, which is notable for its rareness and unique pattern, distinct from previously reported cases.

Laparoscopic Excision of a Urachal Cyst Containing Large Stones in an Adult

Stone-containing urachal cysts are extremely rare in adults. Here, we report the case of a 58-year-old man with a urachal cyst who had lower abdominal pain and urinary frequency. Abdominal ultrasonography and computed tomography showed hyperdense stones in the urachus. He was treated with a laparoscopic excision using a transperitoneal approach. The pathological diagnosis was an inflammed urachal cyst. This rare case illustrates an inflammed urachal cyst containing stones treated with laparoscopy.

Influence of Obesity on Laparoscopic Radical Nephrectomy / 대한비뇨기과학회지

PURPOSE: Our intension was to identify the influence of obesity on the operative results of laparoscopic renal surgery. Our study was performed on the basis of the body mass index(BMI). MATERIALS AND METHODS: Between March 2003 and December 2006, patients with localized renal cell cancer, who underwent a laparoscopic radical nephrectomy, were included in the study. The patients were divided into 3 groups according to their BMI: group I(BMI25). Patients with abdominal operation or radiation exposure histories were excluded from the study. The study started at the time of operator's overcoming of the learning curve for a laparoscopic radical nephrectomy. The operative data were retrospectively reviewed. RESULTS: Forty-one patients were included in the study. The mean ages of the three groups were 61.2+/-6.7, 58.2+/-6.1 and 59.2+/-5.7 years, respectively. The mean BMI were 20.3+/-2.6, 24.1+/-0.8 and 27.9+/-2.2 in groups I, II and III (n=15, 12 and 14), respectively. According to the degree of obesity, the operation time was meaningfully increased in group III(group I: 162.1+/- 39.4, group II: 147.5+/-17.5, group III: 199.4+/-2.2 minutes). The complications of a laparoscopic radical nephrectomy, including transfusion rate, had no relation with the degree of obesity. CONCLUSIONS: For a laparoscopic radical nephrectomy, obesity could influence the operative time, but not the complications.

Early Experience with Transobturator Vaginal Tape Inside-out(TVT-O) Procedure for the Treatment of Female Stress Urinary Incontinence

PURPOSE: Tension free vaginal tape, which has become the common therapy for female stress urinary incontinence, has a complication associated with a blind passage. Transobturator vaginal tape inside-out (TVT-O) is a technique for the passage of the tape through the obturator foramens from inside to outside. We intend to evaluate the efficacy and safety of the TVT-O. MATERIALS AND METHODS: From September 2004 to December 2004, 35 patients underwent TVT-O under spinal anesthesia. Among them, 30 patients have been followed-up more than 12 months. The preoperative assessment included past history, physical examination, voiding diary, 1-hour pad test, urinalysis, voiding cystourethrography (VCUG), urodynamic study. Post-operatively a 16 Fr urethral Foley catheter was left for 24 hours. The procedural outcome, subjective satisfaction and complications were assessed retrospectively. RESULTS: The mean operative time was 15 minutes (range 12~20). Average hospital stay was 3.5 days (range 2~14). No intraoperative or postoperative complications were noted. One patient had immediate voiding difficulty, which was resolved after 2 weeks of clean intermittent catheterization. Three out of 10 patients (30%) with urge incontinence improved after the operation. The mean followed-up period was 13 months. Of 30 patients, 29 patients (96.6%) were cured and 1 patient (3.3%) improved. Subjective cure was present in 29 patients (96.6%). CONCLUSION: TVT-O is a simple, safe and effective surgical treatment for female stress urinary incontinence. However, a longer follow-up will be necessary to determine its long-term effect.

Testicular T-cell Lymphoma / 대한비뇨기과학회지

Testicular lymphomas are rare, accounting for only 5% of all testicular tumors. The majority of these tumors are part of the disseminated disease process, and only rarely arise as a primary lesion. Most testicular lymphomas are B-cell lymphomas. Testicular T-cell lymphomas, are rarely detected, but have many subtypes according to the immunohistological feature, and have poor outcome and high relapse rates, even with a localized disease. Herein, 2 cases of testicular T-cell lymphoma, initially manifesting in the testis, are reported, with a review of the clinical features and outcomes.

Laparoscopic Pyeloplasty with Transperitoneal Approach for Ureteropelvic Obstruction / 대한비뇨기과학회지

PURPOSE: Laparoscopic pyeloplasty is an alternative, minimally invasive approach for the repair of an ureteropelvic junction obstruction (UPJO). However, it has a technical difficulty, and various laparoscopic approaches are available. We present our initial experience of laparoscopic pyeloplasty using a transperitoneal approach in patients with an UPJO. MATERIALS AND METHODS: Between January 2002 and January 2004, 11 patients underwent laparoscopic pyeloplasty using a transperitoneal approach. Of these 11, 10 patients were followed up and enrolled in this study. They were comprised of 6 males and 4 females, with a mean age of 44 years (19-62). The chief complaints were flank pain in 8 patients, with a further 2 incidental detected. Three patients had had previous abdominal surgeries. The mean length of stricture was 1.1cm in the radiologic studies, and the degree of hydronephrosis was grade 3/4 in 6 patients and grade 4/4 in 4. An obstructive pattern in the 99mTc-MAG3 renal scan was present in 9 patients. RESULTS: Eight patients were treated with dismembered Anderson-Hynes pyeloplasty and 2 patients with Fenger pyeloplasty. The mean operating time and hospital stay were 225 minutes (120-450) and 7.4 days (5-10), respectively. During the operation, crossing vessels were found in 4 patients and an ureteral polyp in 1. One patient had an ascending colon injury, which was postoperatively detected and repaired. The mean follow- up period was 42.5 weeks (26-135). Follow-up excretory urography and a 99mTc-MAG3 renal scan showed improvements in 8 of the 10 patients (80%) at the 3 month follow-up. The flank pain disappeared in all the patients (100%) who had previously complained of this symptom. CONCLUSIONS: Laparoscopic pyeloplasty could be an alternative treatment for an ureteropelvic junction obstruction, especially using a transperitoneal approach, which seems to have a technical convenience over that of the retroperitoneal approach.

Laparoscopic Excision of Complicated Urachal Cyst in Child / 대한비뇨기과학회지

A complicated urachal cyst requires surgical excision to prevent symptom recurrence and complications, most notably malignant degeneration. However, a traditional open excision is associated with significant morbidity and prolonged convalescence, especially in children. A seven year old male, with a complicated urachal cyst, underwent a laparoscopic excision of the urachal remnant. Through a transperitoneal approach, using three ports, the urachus was excised and separated from the bladder dome. We report our experience of a laparoscopic excision of an urachal cyst, with a review other reports, to find the efficacy and outcome of this approach as a minimally invasive alternative.

The Success Rate and Complications of the Primary Endoscopic Urethral Realignment within 3 Days in Male Urethral Injury / 대한비뇨기과학회지

PURPOSE: Attempts have been made to insert a urethral Foley catheter as a primary urethral realignment immediately after a urethral injury. There has been much debate about the time and method of the realignment. The feasibility and complications of early primary endoscopic realignment in a urethral injury were evaluated. MATERIALS AND METHODS: From November 1990 to May 2003, 63 patients with urethral injuries received early endoscopic realignment within 72hrs. The diagnosis was made by retrograde urethrography. Primary realignment was successfully performed for 61 patients; 52 (85.2%) had an anterior urethral injury and 9 (14.8%) a posterior urethral injury. All operations were performed under spinal anesthesia. A cystoscope was inserted through the dilated suprapubic cystotomy and a guide wire passed through the cystoscope, and caught by transurethral foreign body forceps just distal to the injured site. The urethral catheter was removed after pericatheter urethrography, usually on the 14th postoperative day. Patients were retrospectively reviewed for complications, including urethral stricture, urinary incontinence and erectile dysfunction. RESULTS: Of the 63 patients, 61 (96.8%) were successfully treated. The mean operation and catheter indwelling times were 71.8 minute (5-109) and 17.4 days (6-32), respectively. The mean follow-up duration was 423.2 days (94-1432). Urethral strictures were detected in 14 patients (23.0%), who were treated with an internal urethrotomy. Urinary incontinence in 5 patients (8.2%) and erectile dysfunction in 14 patients (23.0%) were the observed complications. CONCLUSIONS: Our results show that immediate endoscopic realignment is a less invasive and more feasible therapy for patients with a urethral injury.

Gene Expression Changes Associated with Sustained p16 Expression in Hepatocellular Carcinoma Cells

BACKGROUND: The normal functions of the cell cycle inhibitor p16INK4a are frequently inactivated in many human cancers. Over 80% of hepatocellular carcinoma (HCC) cases lack a functional p16/Rb pathway. p16/Rb pathway, as well as p53 pathway, is considered as one of key components of tumor suppression. METHODS: To study the roles of p16INK4a in HCC, a stable cell line expressing exogenous p16 was generated from SNU-449 hepatocellular carcinoma cells lacking endogenous p16, and suppression subtractive hybridization (SSH) was performed in parallel with the control cells. RESULTS: 1) SSH identifies fibronectin (FN1), crystallin alphaB (CRYAB), Rac1, WASP, RhoGEF, and CCT3 as differentially-expressed genes. 2) Among the selected genes, the up- regulation of FN1 and CRYAB was confirmed by Northern blot, RT-PCR and by proteomic methods. CONCLUSION: These genes are likely to be associated with the induction of stress fiber and stabilization of cytoskeleton. Further studies are required to clarify the possible role of p16 in the signal transduction pathway.

Study on the expression and detection of the p53 mutation in Korean colon cancer cell lines

BACKGROUND: Inactivation in p53 tumor suppressor gene through a point mutation and deletion is one of the most frequent genetic changes found in human cancer, with 50% of an incidence. This high rate of mutation mostly suggests that the gene plays a central role in the development of cancer and the mutations detected so far were found in exons 5 to 8. Mutation of p53 locus produced accumulation of abnormal p53 protein, and negative regulation of cell proliferation and transcriptional activation as a suppressor of transformation were lost . In addition, inhibition of its normal cellular function of wild-type by mutant is an important step in tumorigenesis. METHOD: 4 colon cancer cell lines (SNU C1, C2A, C4, C5) were examined for mutation in exons 5 to 8 of the p53 tumor suppressor gene by PCR-SSCP analysis and expression pattern by western blotting and immunoprecipitation. p53-mediated transactivation ability were examined by CAT assay and base substitution of p53 in SNU C2A cell were detected by DNA sequencing. RESULTS: 1) SNU C2A cell and SNU C5 cell were detected mobility shifts each in exon 5 and exon 7 of p53 gene by the PCR-SSCP method, implicating being of p53 mutation. 2) 3 colon cancer cell lines (SNU C1, SNU C2A, SNU C5) expressed wild type and mutant type p53 protein. 3) In northern blot experiment, SNU C2A and SNU C5 cell expressed high level of p53 mRNA. 4) Results of p53-mediated transactivation in colon cancer cell lines by CAT assay represented only SNU C2A cell has transcriptional activity. 5) DNA sequencing in SNU C2A cell showed missense mutation in codon 179 of one allele, histidine to arginine and wild type p53 in the other allele. CONCLUSION: Colon cancer cell lines showed correlation with mutation in p53 gene and accumulation of abnormal p53 protein. Colon cancer cell SNU C2A retained p53-mediated transactivation as heterozygous p53 with one mutant allele in 179 codon and the other wild-type allele.

Induction of apoptosis by etoposide treatment in colon cancer cell line SNU C2A

No abstract available.

Tumoricidal Effect of Taxol on Murine Bladder Tumor-2 (MBT-2) cells via Nitric Oxide Production / 대한비뇨기과학회지

PURPOSE: Taxol, an anticancer drug, blocks cell division by stabilizing microtubules. However, taxol has distinct cell-cycle-independent effects. For example, taxol and interferon gamma(IFN-gamma) induce tumoricidal activity of murine peritoneal macrophages. This study was designed to know whether taxol has indirect tumoricidal effect on murine bladder tumor-2(MBT-2) cells besides its direct cytotoxicity. MATERIALS AND METHODS: The original stock of C57BL/6 mice were used at 8 to 12 weeks of age. Macrophages were obtained by peritoneal lavage from the mice which had been treated with thioglycollate. The tumor target cells were MBT-2 cell line. MBT-2 cells were cultivated in different concentration of taxol for various times and the growth of MBT-2 cells were tested. Tumoricidal activitiy was measured by indirect methylthiazol-2-yl-2,5-diphenyl tetrazolium bromide(MTT) assay after co-cultures of stimulated macrophage and MBT-2 cells with taxol, INF-gamma, lipopolysaccharide(LPS) or with combination of taxol and INF-gamma or LPS and INF-gamma. Nitric oxide(NO) formation was measured by Griess method under the same conditions. Effect of NG -monomethyl-L-arginine(NGMMA) on nitrite formation and cytotoxicity toward MBT-2 cells were also evaluated. RESULTS: Significant retardation of cell growth was observed after treatment of tumor cells with taxol in a dose dependent manner but does not affect cell viability. Taxol(19+/-2%) or LPS(19+/-4%) alone weakly activated macrophages to kill MBT-2 cell lines, whereas combinations of taxol(77+/-3%) or LPS(75+/-4%) with IFN-gamma(control: 2%, IFN-gamma:18+/-3%) synergized to activate macrophages to kill tumor cells in a dose dependent manner. Taxol(20+/-5microM), LPS(15+/-5microM) or IFN-gamma(25+/-3microM) alone induced small amounts of NO secretion but the combinations of either taxol and INF-gamma(73+/-5microM) or LPS and IFN-gamma(77+/-5microM) synergistically induced large amounts of NO secretion. The production of NO(control:<5, IFN-gamma+ taxol: 73+/-5microM, IFN-gamma+ taxol + NGMMA: 15+/-3microM) and tumor cell killing(control: 2%, IFN-gamma+ taxol: 77+/-3%, IFN-gamma+ taxol + NGMMA: 20+/-3%) were blocked in the presence of NGMMA, a competitive inhibitor of NO synthase. CONCLUSIONS: Collectively, the data indicate that taxol is directly non-cytotoxic for MBT-2 cells via its effect on micrtubules but indirectly activates macrophages to kill MBT-2 cells probably via NO secertion.

Tumoricidal Effect of Taxol on Murine Bladder Tumor-2 (MBT-2) cells via Nitric Oxide Production / 대한비뇨기과학회지

PURPOSE: Taxol, an anticancer drug, blocks cell division by stabilizing microtubules. However, taxol has distinct cell-cycle-independent effects. For example, taxol and interferon gamma(IFN-gamma) induce tumoricidal activity of murine peritoneal macrophages. This study was designed to know whether taxol has indirect tumoricidal effect on murine bladder tumor-2(MBT-2) cells besides its direct cytotoxicity. MATERIALS AND METHODS: The original stock of C57BL/6 mice were used at 8 to 12 weeks of age. Macrophages were obtained by peritoneal lavage from the mice which had been treated with thioglycollate. The tumor target cells were MBT-2 cell line. MBT-2 cells were cultivated in different concentration of taxol for various times and the growth of MBT-2 cells were tested. Tumoricidal activitiy was measured by indirect methylthiazol-2-yl-2,5-diphenyl tetrazolium bromide(MTT) assay after co-cultures of stimulated macrophage and MBT-2 cells with taxol, INF-gamma, lipopolysaccharide(LPS) or with combination of taxol and INF-gamma or LPS and INF-gamma. Nitric oxide(NO) formation was measured by Griess method under the same conditions. Effect of NG -monomethyl-L-arginine(NGMMA) on nitrite formation and cytotoxicity toward MBT-2 cells were also evaluated. RESULTS: Significant retardation of cell growth was observed after treatment of tumor cells with taxol in a dose dependent manner but does not affect cell viability. Taxol(19+/-2%) or LPS(19+/-4%) alone weakly activated macrophages to kill MBT-2 cell lines, whereas combinations of taxol(77+/-3%) or LPS(75+/-4%) with IFN-gamma(control: 2%, IFN-gamma:18+/-3%) synergized to activate macrophages to kill tumor cells in a dose dependent manner. Taxol(20+/-5microM), LPS(15+/-5microM) or IFN-gamma(25+/-3microM) alone induced small amounts of NO secretion but the combinations of either taxol and INF-gamma(73+/-5microM) or LPS and IFN-gamma(77+/-5microM) synergistically induced large amounts of NO secretion. The production of NO(control:<5, IFN-gamma+ taxol: 73+/-5microM, IFN-gamma+ taxol + NGMMA: 15+/-3microM) and tumor cell killing(control: 2%, IFN-gamma+ taxol: 77+/-3%, IFN-gamma+ taxol + NGMMA: 20+/-3%) were blocked in the presence of NGMMA, a competitive inhibitor of NO synthase. CONCLUSIONS: Collectively, the data indicate that taxol is directly non-cytotoxic for MBT-2 cells via its effect on micrtubules but indirectly activates macrophages to kill MBT-2 cells probably via NO secertion.

Results of Primary Endoscopic Urethral Realignment as a Treatment of Urethral Injury According to the Injury Site / 대한비뇨기과학회지

PURPOSE: There are a variety of open surgical and endoscopic methods to the treatment of urethral injuries. The objective of our study is to evaluate the efficacy of primary endoscopic urethral realignment according to the injury site. MATERIALS AND METHODS: Twenty eight patients with urethral injuries(23 anterior and 5 posterior) were treated by primary endoscopic urethral realignment from March 1990 to August 1997. According to the injury site, age distribution, etiology of injury, associated injuries, time to operation, operating time, duration of urethral Foley catheterization, maximal flow rate, postoperative complications and treatment of post-realignment stricture were reviewed. RESULTS: The age range of our patients was from 20 to 86 years(mean 45.0). Among the 28 patients, 23 were anterior and 5 were posterior urethral injuries. Pelvic bone fracture was associated in 1 patient(20.0%) in the anterior urethral injury group, while 5 patients(100%) in the posterior urethral injury group. The mean time after injury to realignment was 1.9 days (range 0 to 9) and the mean operating time was 53.9 minutes in the anterior urethral injury group(range 20-190) and 79.0 minutes in the posterior urethral injury group(range 25-170). The mean duration of urethral Foley catheterization was 24.5 days in the anterior urethral injury group and 61.4 days in the posterior urethral injury group. The mean maximal flow rate after catheter removal was 31.4ml/sec in the anterior urethral injury group and 24.6ml/sec in the posterior urethral injury group. Of the 23 patients, 9 patients(39.1%) had post-realignment strictures in the anterior urethral injury group and 8 were treated with visual urethrotomy, and only one patient was required open urethroplasty. Of the 5 patients, 4 patients(80.0%) had post-realignment strictures in the posterior urethral injury group and treated with visual urethrotomy. CONCLUSIONS: Primary endoscopic urethral realignment is a safe and simple technique with minimal mobidity regardless of injury site. The stricture formation, impotence and incontinence rates of this technique are comparable to those reported for open surgical methods. Finally, most post-realignment strictures can be treated successfully with visual internal urethrotomy with or without occasional sound dilation.

A Case of Neurogenic Bladder Combined with Mayer-Rokitansky- K ster-Hauser Syndrome / 대한비뇨기과학회지

We experienced a case of MRKH syndrome in a 24-year-old female which was combined with sacral agenesis, neurogenic bladder, and duplicated ureter associated with vesicoureteral reflux in the right side.